This invention relates to a surgical instrument assembly. More particularly, this invention relates to a clamping device for use in surgery. This invention also relates to an associated surgical method or procedure.
During surgical operations, one of the most important operations is the spreading of convoluted and folded organic tissues to enable visual inspection and physical access to a potential surgical site. Generally, such access is achieved by initially attaching a first clamp to tissues on one side of the desired site and a second clamp to tissues on the opposite side of the site. The clamps are then pulled apart, by surgical assistants, to spread the tissues between the two clamps.
Such a procedure, although useful and effective in open surgery, could be streamlined. In addition, the procedure is cumbersome if used in laparoscopic surgery.
Laparoscopy involves the piercing of a patient's abdominal wall and the insertion of a cannula through the perforation. Generally, the cannula is a trocar sleeve which surrounds a trocar during an abdomen piercing operation. Upon the formation of the abdominal perforation, the trocar is withdrawn while the sleeve remains traversing the abdominal wall. A laparoscopic instrument, such as a laparoscope or a forceps, is inserted through the cannula so that a distal end of the instrument projects into the abdominal cavity.
Generally, in a laparoscopic surgical procedure, three or four perforations are formed in the abdomen to enable deployment of a sufficient number of laparoscopic instruments to perform the particular surgery being undertaken. Each perforation is formed by a trocar which is surrounded by a sleeve, the sleeves or cannulas all remaining in the abdominal wall during the surgical procedure.
Prior to insertion of the first trocar and its sleeve, a hollow needle is inserted through the abdominal wall to enable pressurization of the abdominal cavity with carbon dioxide. This insufflation procedure distends the abdominal wall, thereby producing a safety space above the patient's abdominal organs.
Laparoscopic surgery provides several advantages over conventional incision-based surgery. The laparoscopic perforations, in being substantially smaller than the incisions made during conventional operations, are less traumatic to the patient and provide for an accelerated recovery and convalescence. Hospital stays are minimized. Concomitantly, laparoscopic surgery is less time consuming and less expensive than conventional surgery for correcting the same problems.
To enable access to a desired surgical site during a laparoscopic operation, the tissue spreading procedure described above requires the formation of at least four abdominal perforations and the insertion of four trocar sleeves. Two sleeves are required for the clamps, another sleeve for the laparoscope and a fourth sleeve for an instrument (e.g., scalpel, forceps, cautery probe, etc.) to perform a surgical operation at the sugical site which has been made visible by the tissue spreading procedure.